Access Platinum 2 by Univera Healthcare
Scroll down to the Summary of Benefits PDF
Plan Information
- Plan Name
- Access Platinum 2
- Insurance Company
- Univera Healthcare
In Network Benefits
- Office Co-pay
- $5
- Specialist Co-pay
- $30
- Hospital Co-pay
- $500
- Emergency Room
- $150
- Referrals Needed
- No
- Rx: Generic/Brand/High Brand
- $5/$45/$50
- In-Network Deductible (single/family)
- $0
- In-Network Co-Insurance
- 0%
- Max Out of Pocket (single/family)
- $5,500/$11,000
Out Of Network Benefits
- Deductible (single/family)
- $2,000/$4,000
- Co-Insurance
- 40%
- Out of Pocket Max (single/family)
- $11,000/$22,000
Other Benefits
- Vision/Dental
- Pediatric Vision and Dental; Adult Vision Only
- Renewal Date
- Annual
- HSA Eligible
- No
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